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world journal of hepatology
Baishideng Publishing Group
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Abstract: |
Hepatitis C virus (HCV) infection may affect lipid metabolism by enhancing the
circulating levels of inflammatory cytokines, together with its impact on
endothelial function.
AIM
To evaluate the potential correlation of changes in lipid profile, carotid intimamedia
thickness (CIMT), and ankle-brachial index with the severity of fibrosis,
grades of esophageal varices (EVs), and fibrosis indices.
METHODS
The study included 240 subjects who were divided into 3 groups; group 1 (n = 90,
HCV-related cirrhotic patients with EVs), group 2 (n = 90, HCV-related cirrhotic
patients without EVs), and group 3 (n = 60, served as the healthy control group).
All patients underwent routine laboratory tests, including a lipid profile assay.
Low-density lipoproteins (LDL)/platelet count and platelet/splenic diameter
ratios were calculated. Abdominal ultrasonography, CIMT by carotid Doppler,
bedside ankle-brachial index (ABI), liver stiffness measurement, and upper
gastrointestinal endoscopy were performed.
RESULTS
Multivariate logistic regression revealed that very-low-density lipoprotein
(VLDL) (β = 0.988, odds ratio 2.5, P = 0.001), LDL/platelet count ratio (β = 1.178,
odds ratio 3.24, P = 0.001), CIMT (β = 1.37, odds ratio 3.9, P = 0.001), and ABI (β =
2.3, odds ratio 5.9, P = 0.001) were the key variables associated with significant
fibrosis, EVs and endothelial dysfunction. CIMT and LDL/platelet count ratio
were predictive of advanced fibrosis and EVs at cutoff values of 1.1 mm and 1
mm, respectively, with an area under the curve (AUC) of 0.966 and 0.960 (P =
0.001), while VLDL and ABI at a cutoff of 16.5 mg/dL and 0.94 were predictive of
advanced fibrosis and EVs with an AUC of 0.891 and 0.823, respectively (P =
0.001).
CONCLUSION
CIMT, ABI, VLDL, LDL/platelet count ratio are good non-invasive predictors of
advanced fibrosis, presence of EVs, and endothelial dysfunction in liver cirrhosis.
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